Thank you for taking the time to complete this very important application. Since we are not able to meet most of you in person, we will need some information to insure we provide you with the best possible puppy match for your family. Please complete all of the following questions.

Janice (320)224-0783


Date: ________________

Applicant's Names: 

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Street address, mailing address (if different), City, State or zip code:

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Home and work phone numbers - fax number (if available)

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Cell phone number:

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Email address: (Used for future correspondence) 

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Family members, names, ages:

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Occupation of all adults living in the household. 

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How many hours will the puppy be alone each day? __________________

Do you live in an apartment or house?_____________________________

Do you have a fenced yard or environment outside, in which dog can run but be contained? Please describe:

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Present pets- breeds, ages, male, female, neutered, spayed?

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Name of Veterinarian. May we contact? Name, address, phone number.

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Why have you chosen the Havanese / Bolognese (whichever is applicable!) breed ?

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Are you looking for a Show/Breeding or a Companion puppy? ___________________

Companion puppies are only available on an ironclad spay/ neuter contract, which requires spay/neuter prior to 8 months of age.

Papers will be provided only after proof of spay/neuter.

Would you be happy with a male, female or either gender? _____________

Would you be just as happy with a neutered male as a female? ____________

Neutering males at 6 months provides the sweetest of all possible pets. Neutering at 6 months preserves the puppy personality for an extended period of time, providing a more playful and obedient puppy.

What temperament qualities are you looking for? 

A: Most inquisitive 
B: Medium 
C: Mostly quiet. 
Please add any other details that you feel are pertinent for me to consider when choosing the best puppy for your lifestyle. 
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If you have color preferences, please list them in order. Remember that it’s pure guesswork when trying to ascertain what colors to expect with the Havanese breed. Bolognese are white in color.

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If you obtained a dog from Charmin Havanese and Bolognese, would you return it to us if, for any reason
you were unable to keep it? 

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Please include the name, address and phone number of an acquaintance who would be willing to provide a reference for you.

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Do you wish to breed your dog? 

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Have you ever had a litter of puppies? If so, please describe.

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Are you a breeder? 

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Have you ever worked in the pet industry?

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Have you ever owned a show animal:

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Do you have family or friends who are breeders, or who work in the pet industry? If so, please describe:

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Where did you learn about Charmin Havanese and Bolognese? Internet, magazine or other.
Please specify which internet site or magazine: 

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We would love if you would provide us with a occasional photo of your Charmin Puppy!

If a puppy is provided to applicant, this application shall become part of the contractual agreement between buyer and seller. Deliberate falsification of this application shall cause return of animal to Charmin Havanese & Bolognese, seller, without remuneration, and with all transportation costs and veterinary fees being the responsibility of buyer.



Applicant #1 Signature ___________________________________ Date ________________

Applicant #2 Signature ___________________________________ Date ________________




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(This section is for office use )

Date of Received: ______________  Deposit Received: ______________

Notes:

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Please copy and paste the following text into an email, fill in your answers, and email to: brookviewalpacas@tds.net